Saturday, June 8, 2013


Ellen: "I can't believe somebody ate all my "I Can't Believe It's Not Butter!"
Me: "Unbelievable"
Pirate: "She is sufferering from Half-a-deck-a-cardia"
(as in not playing with a full deck)
Patient's Significant Other: "This is an emergency!  Why isn't anybody getting all excited??"
(as in life-threatening finger boo-boo)

Let me just add a personal  note to this last one:  the more excited you get, the less excited I become.  And I think I can speak for most ER nurses and add a  sidebar to the general public:  If I AM excited, you had better be afraid.....very afraid.
Partner in Crime: "Why do people call the ER when they have been sick for three days and ask if they should come in?"
Me: "Because when you are a douchebag, the world is your oyster"
Me: "So how many sutures was that in total" (for charging purposes of course, like we don't have better things to do
Parvati" "Well, three on the outside of this one, no, four.  Um, 16"
Me: "So....I guess I should figure the value of X?"
T-shirt of a wonderfully vibrant, health and active 80 year old woman: "In Dog Years, I Would Dead Now"

You're Killing Me Smalls

It has been about a year since my facility rolled our JCAHO mandated  Electronic Medical Record, AKA the Shittiest Computer Program Ever Devised (SCPED).

Every so often there will be an update to SCPED that entails shutting down the system for 12 or more hours, during which the entire electronic charting and ordering system is unavailable.  Which means:

1.  All charts will be paper charts
2.  All orders will be written by hand, a copy made and delivered to the lab/xray/pharmacy, which will then
3.  Enter all the orders on each of their separate systems which apparently don't get updated

Of course paper generated charts just means more work for everyone. Each patient gets a pre-determined ID number.  Those ID numbers are HAND LETTERED (does that make them artisanal, Dr. Grumpy?) on labels to be used for a variety of things.  Like X-ray and lab draws.  The secretary does this, adding to the already cumbersome registration process.

A couple of weeks prior to SCPED updates there will  bulletins, notices, reminders and memos announcing DOWNTIME procedures.  Basically, to brush up on DOWNTIME protocol and stock up on paper and prepare for Electronic Armageddon.

During the most recent SCPED update there were specific instructions for removing current patients from the tracking board so that they would not be irretrievably committed to THE VOID, which had occurred during the previous update.  In order to prevent this, all patient charts were to be printed off 30 minutes prior to DOWNTIME.  I personally received calls from 6 different people each giving me a different deadline for the paper festivities before I told the secretary to just take a message.  It is no wonder there is such chaos.

"OK, downtime starts at 10:00 PM....print off the records about 20 minutes prior to that"
"OK, do this.  Any patients who come in after 9:30 PM, just do a paper record.  Don't start them in the computer.  Start printing any patients in the department at that time"
"Did you get that last message?"
(Different tech weasel) "You should print off starting at about 9:15 PM.
(Still another tech weasel)  "Probably should start going paper about 9:00 PM"

Me, to Ellen: "Next time someone calls, just tell them we're already on downtime".  It was 5:00 PM.

Following updates computers slow down to crawl or outright freeze.  None of the updates goes well with our elderly operating systems.

Pirate: "Jeez, it's like we have the first version of Windows, like  Windows 1.2.
Me: " Our versions of Windows are so old that it is more Porthole".

For added fun updates are always done on a weekend when only the people who actually take care of patients work.  This gets extremely frustrating; patients don't like the little signs posted by the tech weasels any more than we do.

"Thank You For Your Patience While Our Computers Are Updating!".  The clever little hopping frog graphic was immediately replaced by me.  With a picture of a snail.

That about covers the Shittiest Computer Program Ever Devised tutorial.  Although there is some hope.  We are updating all the computers with a newer (but not the newest) version of Windows within 2 years.  And an entirely new Electronic Medical Record System will be up and 3 years.

Psyched.  Now if the computers  could be updated maybe we wouldn't have to trip over all these wires.

Can't we have a nice little Mac? 

Does this look safe?